升阳通督针法对脑梗死患者脑电地形图、神经血管单元功能和心率变异性影响的临床研究  

Clinical study on effect of Shengyang Tongdu acupuncture on electroencephalography topography,neurovascular unit function and heart rate variability in patients with cerebral infarction

作　　者：马崇[1] 李姣[1] 王晓娜 常永霞[1] MA Chong;LI Jiao;WANG Xiaona;CHANG Yongxia(Department of Rehabilitation Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院康复医学科,河北张家口075000

出　　处：《上海中医药杂志》2021年第9期50-54,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：河北省卫健委科研基金项目(20170812);河北省财政厅老年病防治项目(冀财预复[2020]459号)。

摘　　要：目的观察升阳通督针法联合肌电生物反馈训练治疗脑梗死的临床疗效及其对患者脑电地形图、神经血管单元功能和心率变异性的影响。方法将90例脑梗死患者随机分为治疗组与对照组,每组45例。两组均给予神经内科基础治疗,对照组加予肌电生物反馈训练,治疗组在对照组治疗措施基础上加予升阳通督针法治疗。两组疗程均为4周,观察治疗措施安全性,比较脑卒中相关量表评分、中医证候积分、心率变异性相关指标、脑电地形图相关指标、神经血管单元功能相关指标的变化情况。结果(1)最终完成试验者83例,治疗组42例,对照组41例。(2)组间治疗后比较,治疗组美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer评分、Bartherl指数的改善明显优于对照组(P<0.05)。(3)组间治疗后比较,治疗组心率总体标准差(SDNN)、差值的平方根(RMSSD)、相邻两个RR间期差50 ms的百分数(PNN50),血清基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)水平以及脑部β、δ、θ频段功率电压的改善均明显优于对照组(P<0.05)。(4)组内治疗前后比较,两组中医证候积分均明显降低(P<0.05);组间治疗前后中医证候积分差值比较,治疗组明显高于对照组(P<0.05)。(5)两组均未出现严重不良反应病例。结论升阳通督针法配合肌电生物反馈训练治疗脑梗死,能显著缓解临床症状,促进神经功能恢复,提高患者的生活能力,其机制可能与改善大脑神经电生理活动、神经血管单元功能及自主神经系统功能有关。Objective To observe the clinical efficacy of Shengyang Tongdu acupuncture combined with electromyographic(EMG)biofeedback training in the treatment of cerebral infarction and its effect on patients’electroencephalography(EEG)topography,neurovascular unit function and heart rate variability(HRV).Methods Ninety patients with cerebral infarction were randomly divided into a treatment group(n=45)and a control group(n=45).Both groups underwent basic neurological treatment,while the control group was additionally given EMG biofeedback training and the treatment group was additionally given Shengyang Tongdu acupuncture treatment and EMG biofeedback training.The treatment course was 4 weeks in both groups.The safety of the treatment measures was assessed,and the changes in the stroke related scale scores,traditional Chinese medicine(TCM)syndrome scores,heart rate variability related indexes,EEG topography related indexes and neurovascular unit function related indexes were compared.Results(1)Finally 83 cases completed the trial,42 cases in the treatment group and 41 cases in the control group.(2)After treatment,the improvement of National Institutes of Health Stroke Scale(NIHSS)score,Fugl-Meyer score,and Bartherl index in the treatment group was significantly better than that in the control group(P<0.05).(3)After treatment,the standard deviation of all normal to normal NN intervals(SDNN),the square root of the mean of the squares of successive NN interval differences(RMSSD)and the percentage of NN intervals>50 ms different from preceding interval(PNN50)of heart rate,and the levels of serum matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)in the treatment group were significantly higher than those in the control group(P<0.05);the improvement of power voltage in the beta(β),delta(δ)and theta(θ)bands of the brain in the treatment group were significantly better than those in the control group(P<0.05).(4)After treatment,the TCM syndrome scores were sig

关 键 词：脑梗死 中风病 升阳通督法 针刺 肌电生物反馈训练 脑电地形图 神经血管单元 心率变异性 

分 类 号：R246.6[医药卫生—针灸推拿学]